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Shoulder Pain and Dysfunction After Vaccination: A Systematic Review.

Jonathan O Wright1, Whitman Wiggins2, Michael Seth Smith1

  • 1Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, Florida.

JBJS Reviews
|February 1, 2023
PubMed
Summary
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Shoulder injury related to vaccine administration (SIRVA) and other vaccine-related shoulder issues are rare but treatable. Most patients recover with conservative care, but accurate diagnosis guides effective treatment for prolonged shoulder pain after immunization.

Area of Science:

  • Orthopedics
  • Neurology
  • Immunology

Background:

  • Persistent shoulder pain and dysfunction following deltoid muscle inoculations are known, though rare, vaccine complications.
  • The term SIRVA (shoulder injury related to vaccine administration) is often used, but distinct pathologies can present similarly after vaccination.

Approach:

  • A systematic literature review was conducted using PubMed, analyzing 56 articles on vaccine-related shoulder injuries.
  • Data on patient demographics, vaccine details, presentation, diagnostics, treatments, and outcomes were extracted and categorized.

Key Points:

  • Diagnoses were classified into local inflammatory reactions (SIRVA), brachial neuritis, and direct nerve injury.
  • SIRVA cases included conditions like frozen shoulder and bursitis; most resolved with conservative treatment (physical therapy, analgesics, injections).

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  • Brachial neuritis and direct nerve injury were diagnosed via EMG/NCS, treated nonoperatively, with most patients improving, though some residual weakness occurred.

    • Conclusions:

    • Awareness of diverse pathologies causing prolonged post-vaccination shoulder pain is crucial for medical professionals.
    • Differentiating diagnoses aids in guiding treatment, with nonoperative modalities and corticosteroids often effective.
    • Most patients achieve good outcomes with recovery from pain and functional deficits.